Healthcare Provider Details

I. General information

NPI: 1811315625
Provider Name (Legal Business Name): MACFARLANE DENTAL ASSOCIATES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/31/2014
Last Update Date: 11/12/2025
Certification Date: 11/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

211 BROAD ST STE 106
RED BANK NJ
07701-2009
US

IV. Provider business mailing address

211 BROAD ST STE 106
RED BANK NJ
07701-2009
US

V. Phone/Fax

Practice location:
  • Phone: 732-517-7785
  • Fax: 732-284-3170
Mailing address:
  • Phone: 732-517-7785
  • Fax: 732-284-3170

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberDI15235
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number State

VIII. Authorized Official

Name: DR. GLENN A. MACFARLANE
Title or Position: PRESIDENT/OWNER
Credential: D.M.D.
Phone: 732-530-4020